In his speech before the American Legion on Tuesday, President Obama touted new initiatives intended to improve mental health treatment and support for service members and veterans.

But many of the 19 “new executive actions” aren’t as novel as presented; just over a quarter represent fresh efforts while the remaining either have been in the works for months or were introduced by Congress and now have White House support.

Since 2009, Obama has pledged to make veterans issues a top priority. He has increased the VA budget by more than $50 billion in the past five years and promised to “dramatically improve services” for mental health treatment.

In 2012, speaking before a uniformed crowd at Fort Bliss, Texas, he signed a much-heralded executive order designed to improve access to mental health care services for veterans and service members.

And on Tuesday, he again took on veteran and troop mental health, devoting a portion of his speech to voice his commitment to their well-being.

“So long as any service member or veteran is suffering, or feels like they have nowhere to turn, or doesn’t get the support they need, that means we haven’t done enough,” Obama said.

And the executive actions being touted by the White House are designed to improve health and reduce suicide.

But some veterans advocates question whether the president’s speech was a repackaging of programs that seem to have had little effect to date on healing troubled service members.

“What we need from the president right now is more follow-through and less flash when it comes to helping veterans,” House Veterans’ Affairs Committee Chairman Rep. Jeff Miller, R-Fla., said in a statement following Obama’s speech.

“Things haven’t changed for the better; they’ve changed for the worse,” said Iraq and Afghanistan Veterans of America CEO Paul Rieckhoff. “We’ve had six years of speeches and promises and almost every metric continues to be bad. There are some good steps in this executive action but they are small steps and it’s not a transformative strategy.”

Coming under the “completely new” category are at least five fresh changes, including a new Defense Department policy that will enroll all service members who receive mental health treatment through DoD in the inTransition program, ensuring a “warm hand-off” to VA care.

VA also will revise its drug formulary policy to guarantee that troops who leave military service and move to VA can get the same medications they received from DoD. Currently, VA providers must obtain a waiver if the medication is not in the VA formulary — a policy that has caused gaps in care and led to veterans’ deaths.

VA and the Pentagon also will expand their peer support programs to other settings. For VA, this will mean having peer specialists working with patients in primary care and for DoD, new peer coordinators at 30 special operations locations.

The White House also announced a conference this fall focusing on brain research, PTSD and TBI and a partnership between VA and the Treasury Department to train volunteer tax preparers on mental health awareness.

A few of the announced initiatives focus solely on the Defense Department and capitalize on programs that have been in the works for years. One supports a bill sponsored earlier this year by Rep. Lois Capps, D-Calif., and Rep. Cory Gardner, R-Colo., to eliminate the number of mental health visits allowed under Tricare without a referral.

Another focuses on DoD’s and VA’s efforts to expand their drug take-back programs.

Also, according to the announcement, DoD will, in the next year, expand the Army’s behavioral health data portal to all services to provide access to clinical outcomes data to doctors and medical professionals.

Also, over the next 12 months, the Pentagon will implement a policy that will ease the process for service members or their families to voluntarily secure their firearms of they feel they are at risk for suicide.

The initiative also will put opioid overdose reversal kits in the hands of every first responder on military bases and other areas under DoD control.

In 2012 — the last year the numbers were available from DoD — 11 active-duty personnel of 318 who committed suicide did so by drug overdose, while 476 of 869 attempts were by drugs.

Between 2001 and March 2014, 350,898 Iraq and Afghanistan veterans were seen at VA facilities for PTSD. An estimated 22 veterans die by suicide a day, although that number is likely higher because states report deaths differently and VA relies on statistics provided by individual states.

Obama said the new efforts will help “end the tragedy of suicide among our troops and veterans.”

“We can’t stand idly by on such tragedy,” the president said.

Rieckhoff said the efforts likely will do little to “move the needle forward.”

Noting that many initiatives announced by Obama and then-VA Secretary Eric Shinseki in a major speech in 2009 never became reality, he expressed a desire for the executive branch to develop a comprehensive national strategy to address troop and vets mental health.

“The suicide provisions are good steps forward but they are little pieces. ... What’s the implementation and execution time line? There’s no promise on when this is going to happen,” Reickhoff said.

In the coming months, according to a White House release — and under the bill approved by Congress — VA will launch a recruiting effort for medical professionals and will study where communities need new medical facilities.

VA also will launch a $34.4 million study of 1,800 veterans to prevent suicide among those who have tried to take their own lives before.

And it will create an advisory board of medical experts to guide new VA Secretary Robert McDonald on industry best practices, the secretary told American Legion conference attendees following Obama’s address.

“Together, we can move VA forward with the urgency that the current situation demands with the balanced reforms that will ensure VA is the provider-of-choice for Veterans from Maine to Manila,” McDonald said.

Miller said the actions “fall far short of what’s needed to regain the trust of America’s veterans.”

Rieckhoff also said he remains skeptical.

“We want to see an executive order on suicide. We want to see care. Our members are sick and tired of the bureaucratic debate. If they could get high quality care in a timely manner, they’d be satisfied,” he said.